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Parent Student College and Career Prep Signup

Student Information
Parent/Guardian Information
Other Information


I, the undersigned, individually and as a parent/guardian of the camper, a minor, ask that he/she be admitted to participate in the GEAR UP Summer Camp sponsored by Central Washington University's GEAR UP/SOAR3 program. I do hereby agree to release, discharge, and hold harmless the State of Washington, Central Washington University, it's officers, agents, trustees, employees, and volunteers from any and all liabilities, claims, costs, expenses, injuries, and or/losses that I or my minor child may sustain as a result of my minor's attendance at the GEAR UP summer camp or in the course of activities held in connection with the camp. I hereby give consent for medical treatment and agree to assume all responsibility for payments of medical bills and expenses. Furthermore, I will be responsible for filing all claims with all insurance companies. You have my permission to release a copy of this form to any medical provider treating my child. I also give permission for my child's photograph to appear in GEAR UP promotional materials.

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